While health systems are facing the need to provide better outcomes at a lower cost, there is only so much that can be achieved through consolidation, incentives, and standardization. Most recognize that in order to continue moving the needle on cost, hospitals and health systems will require fundamental redesign in the way care is provided. Business, clinical, and technology thought leadership has an opportunity to create a virtuous cycle where innovation can both inform the direction for and respond to the requirements of care pathway transformation. Mobility, interoperability, and analytics are all required to deliver intelligent data at the moment of care to the care team and consumers.
With this framework, we can approach both immediate and future needs of healthcare in both acute and chronic situations. Consider obstetrics as an example. It is easy to think about technology innovation in the prenatal environment where seconds matter and critical decisions must be made no matter where patients and clinicians happen to be. But it is also important to consider how health systems can provide care most efficiently and effectively across the entire gestational period, and this will require improved data delivery and interpretation outside of the hospital. Integrating antenatal clinical data from office EMRs, home monitoring solutions, and consumer applications into an analytics platform will make it possible to predict, detect, and better manage complex scenarios like gestational diabetes or preeclampsia in novel, low-cost settings. For this to work, care teams will need to coordinate across space and time with more elegant and mobile tools than are currently in widespread use.
By looking at slower moving events, clinicians can think about what they want to prevent in the future and identify clues that could enable earlier intervention. Eventually, this kind of care can be implemented on populations and can better arm our care teams to transform where and by whom care is delivered.
As health systems try to care for populations, care needs to shift to novel settings. What was once managed in the ICU is now in an inpatient unit; inpatient care is shifting to ambulatory environments; office based care is shifting to retail and home settings. As technology enables access to the right intelligent data point (i.e. produced by analytics) in context (i.e. the broader clinical situation only available by accessing multiple different systems in real time), care teams will be able to offer better care in ways that patients want and with fewer critical episodes.
Continuing with our OB example, the obstetrician should increasingly not be rushing into the hospital to make urgent interventions. Instead a care coordinator could be actively monitoring many patients in home and hospital settings, leveraging algorithms to find clues to the slower-moving – but important – situations that could prompt earlier and less urgent management.
Ultimately, healthcare is increasingly connecting to the consumer to become more personal, more meaningful and with higher quality diagnostic data and decision making. Patients are not waiting for health systems to be at the center of activity. Innovative solutions for remote monitoring, diagnosis, and consultation will allow consumers to bypass health systems altogether – with the risk of creating further fragmentation of data and care that may not ultimately be best for them. A better path would be health systems taking the lead on creating a virtuous cycle of care pathway redesign that addresses both consumer desires and reimbursement trend reality.